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Key Points to Review N612 Exam3 Final
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NURS612 Key Points to Review EXAM #3 CUMULATIVE FINAL EXAM KEY POINTS FOR WEEKS 9-14
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NURS612 Key Points to ReviewEXAM #3 CUMULATIVE FINAL EXAM
KEY POINTS FOR WEEKS 9-14
**Please note this is an optional tool for students to use in preparation for
Exam #3. Completing and comprehending this review may or may not contain
all of the content on Exam #3.
Key Point to Review- Abdomen STUDENT NOTES
What are examples of appropriate 1. Onset and duration: when it began;
history of present illness (HPI) sudden or gradual
questions you may ask a patient with a 2. Character: dull, sharp
chief complaint of an abdominal issue? 3. Location and onset: change in
location over time, radiating
4. Associated symptoms: nausea,
vomiting, diarrhea
Describe how you would inspect the inspect the abdomen, perform the
abdomen. following.
• Using tangential lighting,
inspect the abdomen for four
surface characteristics.
First, observe the skin
color. It may vary greatly
but should have no
jaundice, cyanosis, redness,
bruises, or discoloration.
Second, check for nodules
and other lesions, which
should not be present.
Third, note any scars and
draw their location,
configuration, and relative
size on an illustration of the
abdomen.
Fourth, assess the venous
return. Above the
umbilicus, venous return
should be toward the head.
Below the umbilicus, it
should be toward the feet.
Next, inspect the abdominal
contour and symmetry.
The contour is the
abdominal profile from the
rib margin to the pubis. It
normally may be flat,
rounded, or scaphoid. The
umbilicus should be
centrally located and may
be inverted or may protrude
slightly.
N. Zimmermann Spring 2016
,NURS612 Key Points to Review
EXAM #3 CUMULATIVE FINAL EXAM
KEY POINTS FOR WEEKS 9-14
**Please note this is an optional tool for students to use in preparation for
Exam #3. Completing and comprehending this review may or may not contain
all of the content on Exam #3.
Contralateral areas of the
abdomen should be
symmetrical in appearance
and contour and should
have no distention or
bulges.
To elicit hidden masses or
bulges, have the patient
take a deep breath and hold
it. The abdomen should
remain smooth and
symmetrical. Next, have the
supine patient raise their
head from the table as you
inspect the abdomen. Note
any masses, hernia, or
muscle separation.
With the patient’s head at
rest, observe for three types
of abdominal movement.
First, inspect for smooth,
even movement with
respiration.
Second, assess for surface
motion from peristalsis. In
a thin patient, it normally
may be visible. Otherwise,
it may signal an intestinal
obstruction.
Third, note any aortic
pulsation in the upper
midline. Although
pulsations may be visible in
a thin patient, marked
pulsations suggest a
disorder.
Why do you auscultate the abdomen Remember to auscultate before you
before you percuss or palpate? percuss or palpate because these
techniques can alter bowel sounds.
Describe how and where you auscultate Using the diaphragm of a
the abdomen. What are the three warmed stethoscope, listen
N. Zimmermann Spring 2016
,NURS612 Key Points to Review
EXAM #3 CUMULATIVE FINAL EXAM
KEY POINTS FOR WEEKS 9-14
**Please note this is an optional tool for students to use in preparation for
Exam #3. Completing and comprehending this review may or may not contain
all of the content on Exam #3.
additional sounds you assess? What is for bowel sounds and note
normal when you auscultate the their frequency and
abdomen? What is abnormal? character.
Expect to hear clicks and
gurgles at a rate of 5 to 35
per minute.
Note unexpected findings,
such as increased or
decreased bowel sounds or
high-pitched tinkling
sounds.
Auscultate for three
additional sounds.
First, use the stethoscope
diaphragm to detect high-
pitched friction rubs over
the liver and spleen.
Second, use the stethoscope
bell to check for bruits
over the aortic, renal, iliac,
and femoral arteries.
Third, use the stethoscope
bell to assess for a soft,
continuous, low-pitched
venous hum in the
epigastric area and around
the umbilicus.
To palpate the abdomen, perform the
Describe how you palpate the abd. following.
What are you assessing when you Using light palpation,
palpate, light, moderate and deep systematically assess all
palpation? What are the normal and quadrants. But first, try to
abnormal findings? What do the relax the abdominal
abnormal findings indicate as possible muscles. For example,
differential diagnosis? How do you place a small pillow under
palpate for the various abd structrues? the patient’s head and
What are the normal and abnormal slightly flexed knees, warm
findings? What do the findings indicate your hands, take a slow and
as possible differential diagnoses? gentle approach, and save
any tender areas for last.
For light palpation, press in
N. Zimmermann Spring 2016
, NURS612 Key Points to Review
EXAM #3 CUMULATIVE FINAL EXAM
KEY POINTS FOR WEEKS 9-14
**Please note this is an optional tool for students to use in preparation for
Exam #3. Completing and comprehending this review may or may not contain
all of the content on Exam #3.
no more than 1 cm with the
palmar surface of your
fingers.
Expect the abdomen to feel
smooth and soft.
Note any resistance or
tenderness. And watch for
guarding, which should
alert you to proceed with
caution.
Using moderate palpation,
systematically assess all
quadrants in two ways.
First, palpate with the
palmar surface of your
fingers. This may elicit
tenderness that was not
produced by light
palpation.
Second, palpate with the
side of your hand
throughout the respiratory
cycle. As the patient
inhales, you may feel the
liver and spleen bump
gently against your hand.
Using deep palpation,
systematically assess all
quadrants with the palmar
surface of your fingers. If a
patient’s obesity or
muscular resistance makes
deep palpation difficult, try
bimanual palpation with
one hand on top of the
other. With either
technique, feel for the
rectus abdominis muscles,
aorta, and portions of the
colon. Note any tenderness.
If you detect a mass,
evaluate its location, size,
shape, consistency,
N. Zimmermann Spring 2016
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